What Is a Dilation and Curettage (D&C)?
Dilation and curettage (D&C) is a brief surgical procedure to remove tissue from the inside of your uterus. For a D&C, a doctor uses a small instrument and/or medicine to open your cervix . Then, they use another instrument, called a curette, to remove tissue from your uterine lining, by scraping the surface. Sometimes, they may use suction instead.
Knowing what to expect before, during, and after a D&C may help ease your worries and make the process go more smoothly. Here's what you need to know.
Reasons for a D&C
You may need a D&C for one of several reasons. It's done to:
Remove tissue in the uterus. You may need this during or after a miscarriage or abortion or to remove small pieces of your placenta after childbirth. This helps keep you from getting an infection or heavy bleeding.
Diagnose or treat a health condition. A D&C may help diagnose or treat growths such as fibroids, polyps, hormonal imbalances, or uterine cancer. A sample of your uterine tissue is viewed under a microscope to check for abnormal cells.
D&C after miscarriage
You don't necessarily need a D&C if you've miscarried. About 1 in 2 people who miscarry have a D&C. Many people miscarry without many problems when it happens before 10 weeks. You're more likely to need a D&C if you miscarry later in your pregnancy. That's because the miscarriage is more likely to be incomplete.
It also can be a personal choice whether you want to miscarry naturally or have a D&C. You might find it too hard to wait for a natural miscarriage to happen on its own. Your doctor also might recommend a D&C if you have a medical condition or if there are concerns about potential complications.
D&C in abortion
A D&C is one way that you may end a pregnancy. You may also need a D&C if you have a molar pregnancy. In a molar pregnancy, a tumor forms in place of a normal placenta.
D&C for abnormal bleeding
Your uterus normally sheds its inner layer on a regular cycle when you don't get pregnant. This stops after you go through menopause. Any bleeding that happens after menopause or bleeding that's unpredictable or excessive is considered abnormal.
If you have abnormal bleeding, your doctor may examine you and order a variety of tests, including a D&C. A D&C can look for fibroids, polyps, hormonal imbalances, cancer, or other reasons for your bleeding.
What to Expect During a D&C Procedure
You can have a D&C in your doctor's office, an outpatient clinic, or the hospital. It usually takes only 10-15 minutes, but you may stay in the office, clinic, or hospital for up to 5 hours.
Before a D&C
Your complete medical history will be taken, and you will sign a consent form. Ask your doctor any questions you have about the D&C. Be sure to tell the doctor if:
- You think you are pregnant.
- You are sensitive or allergic to any medications, iodine, or latex.
- You have a history of bleeding disorders or are taking any blood-thinning drugs.
You will receive anesthesia, which your doctor will discuss with you. The type you have depends on the procedure you need.
- If you have general anesthesia, you will not be awake during the procedure.
- If you have spinal or epidural (regional) anesthesia, you will feel numb from the waist down and won't feel the procedure.
- If you have local anesthesia, you will be awake and the area around your cervix will be numbed.
Before the D&C, you may need to remove clothing, put on a gown, and empty your bladder.
During a D&C
You lie on your back and place your legs in foot or leg rests called stirrups, as done during a pelvic exam. Then, the doctor inserts a speculum into your vagina and holds your cervix in place with a clamp. Although the D&C won't involve stitches or cuts, your doctor will cleanse your cervix with an antiseptic solution.
A D&C involves two main steps:
Dilation. This step involves widening the opening of the lower part of your uterus (your cervix) to make room to insert an instrument. Your doctor may insert a slender rod (laminaria) into the opening beforehand or use a medicine before your procedure to soften your cervix and make it wider.
Curettage. Your doctor will scrape the lining of your uterus to remove tissue with a long, spoon-shaped instrument (a curette). Your doctor may also use a cannula to suction any remaining contents from the uterus. You may feel some cramping. Your tissue sample then goes to a lab for testing.
Sometimes, other procedures are performed along with a D&C. For example, your doctor may insert a slender device to view the inside of the uterus (called hysteroscopy). Or, they may remove a polyp or fibroid.
After a D&C
A D&C has possible side effects and risks. Common side effects include:
- Cramping
- Spotting or light bleeding
Complications such as a damaged cervix and perforated uterus or bladder and blood vessels are rare. But be sure to contact your doctor if you have any of the following symptoms after a D&C:
- Heavy or prolonged bleeding or blood clots
- Fever
- Pain
- Abdominal tenderness
- Foul-smelling discharge from the vagina
In very rare cases, scar tissue (adhesions) may form inside the uterus. Called Asherman's syndrome, this may cause infertility and changes in your period. Surgery can repair this problem, so be sure to report any abnormal menstrual changes you notice after a D&C.
Recovery After a D&C
After your D&C, you will need someone to take you home. If you had general anesthesia, you may feel groggy for a while and have some brief nausea and vomiting. You can expect to return to regular activities within 1 or 2 days. In the meantime, ask your doctor about any needed restrictions. You may also have mild cramping and light spotting for a few days. This is normal. You may want to wear a sanitary pad for spotting and take pain relievers for pain.
See your doctor for a follow-up visit and schedule any further treatment if needed. If any tissue was sent for a biopsy, ask your doctor when to expect results. They are usually available within a few days.
How many days of rest do you need after a D&C ?
Everyone is different. But most people only need to rest for a day or two. You might have some mild cramping or spotting. Over-the-counter anti-inflammatories or pain medicines can help ease any mild symptoms you have.
What not to do after a D&C
To prevent bacteria from entering your uterus, delay sex and use of tampons until your doctor says it's OK. Don't put anything into your vagina after a D&C. Ask your doctor when it will be safe to have sex, use tampons, or put anything else into your vagina.
Period after D&C
You can expect a change in the timing of your next menstrual period. It may come either early or late. But you should have your next period in 2-6 weeks if you haven't already gone through menopause. The timing will depend on where you were in your menstrual cycle and why you needed to have a D&C. Use pads instead of tampons if you get your period soon after your D&C.
Sex after D&C
Check with your doctor to find out when it's OK to have sex. Usually, it's OK after about a week. The reason is that your cervix needs to go back to its normal size. Before it does, you are at more risk of getting an infection.
Takeaways
A dilation and curettage (D&C) is a quick procedure to remove tissue from your uterus. You may need this for many different reasons. Usually, you'll recover quickly after the procedure and can go back to normal activities within a couple of days. But you should avoid putting anything into your vagina after your D&C until a doctor says it's OK to make an infection less likely.
D&C FAQs
Why would a person need a D&C?
You may need a dilation and curettage procedure for lots of different reasons. It's used to remove extra tissue from your uterus after a miscarriage or abortion. Doctors also use this procedure to get tissue samples if you have abnormal bleeding or other signs of a problem in your uterus.
What happens before a dilation and curettage (D&C)?
Most people recover quickly without any special care. You should rest for a day or two before going back to your regular activities and avoid putting anything into your vagina. If your doctor is running any tests on the uterine tissue they've removed, ask how long it will take to get your results.
How long does a dilation and curettage (D&C) take?
The D&C itself takes only a few minutes, but you should expect to spend several hours at the clinic. Ask your doctor how long you should plan for it to take.
Is having a D&C painful?
You'll probably be sedated or under anesthesia during the procedure, so you shouldn't feel any pain during your D&C. Most people will have only mild cramping or discomfort afterward. If your pain is getting worse, see your doctor right away. Complications of a D&C, including perforation of your uterus or damage to your cervix, are rare but they can happen. Sometimes, scar tissue can form after a D&C, too. When this happens it can lead to more painful periods.
